Visiting the Doctor in Italy

My parents were visiting us recently, and had come down with persistent colds that were beginning to feel like sinus infections because of how long they had dragged on.  That’s a condition best judged by a doctor, and their own doctor was on the other side of the world, in the US.  What to do?  We walked 5 minutes around the block to visit my doctor here in Padova, to ask his advice.

Backing up in the story a little bit, a lot of people are curious about how health care works over here, perhaps imagining that it’s a gigantic, scary bureaucracy.  How do you even choose a doctor?  Are they assigned by the government, or something?  No, actually – when you move to a new town, you can choose from a list of family doctors, or “medici di base” that accept new patients.  Usually there are a few in your neighborhood, within walking, or at most, cycling distance.  Not having any other information to go on, I’ve always chosen them for proximity, so that I can just walk over if I don’t feel well.

Some doctors require an appointment, but most that I’ve dealt with here  do not.  They have office hours that are posted both on line (although those can often be out of date) and at their actual office.  The hours are sometimes fairly limited – a few hours in the morning, a few in the afternoon.  Another important consideration is that a number of doctors, in order to be closer to more people, will have two offices, and perhaps have morning hours at one, and afternoon hours at the other.  It’s important to check where they are in order to avoid going to the wrong place!

Rather than being in a modern, fancy looking office building, most family doctors’ offices are in converted apartments.  That, combined with the very spartan decor in most Italian doctors’ offices, can make them look a bit dingy.  All things considered though, I don’t go to there to hang out and relax, so I’ll take cheap and plain to fancy and very, very expensive.

Generally, there is no paperwork to fill out, since there are no insurance claims.  The doctor might type in that you visited, and for what, and might have to type up a prescription, but as the patient, it’s very rare that you have to do anything other than turn up and let the doctor look at you.

It turns out that my parents were fine: the doctor agreed to see them, and prescribed antibiotics which got them back on their feet in short order.  We probably waited all of 10 minutes in the waiting room to see him, although we were lucky on that count.  My wife and I had one former doctor who always had an interminable wait due to the large number of elderly patients she had.

Thankfully, I don’t have much personal experience with problems more serious than sinus infections, but the quality of care in general seems good, and the doctors and nurses skillful and knowledgeable.  A constant is the lack of “extras”: everything is fairly plain and a bit austere, if functional.  Unless you pay extra, you’ll likely share a room in the hospital, and there won’t be a TV.  Some elective surgery can have long waits, if you opt for the public system.

One of the things that  I like about health care in Italy is the parallel, private system.  Italians complain about having to pay for quicker access to care, which is not a wholly unfounded observation.  However, since the competition (public health care) is free, it means that doctors taking on private patients simply can’t charge too much without driving away most of their patients.  A few years ago, for a bad cough, I got a chest x-ray and a consultation with an ear, nose and throat specialist for under 100 euros, out of pocket.  Try that in the US!

A note on “free”: no, of course it’s not really free.  You pay for the health care here via your taxes.  If you’re out of work, though, you don’t pay into the system, and you never have to worry about being able to take your child to a doctor, even if the lack of a job creates plenty of other worries.  And, when totally up the numbers at a countrywide level, the United States spends nearly twice as much as Italy (World Bank data), even if Italians actually live a bit longer than Americans.

Speaking of sinus infections, a few years ago I was back in the US at Christmas time, and got one.  I paid something like $150 out of pocket to see a nurse practitioner and for the antibiotics I needed.  Almost ten times what my parents paid for the antibiotics they got here in Padova.

All in all, while health care is not perfect here in Italy, and there are things I think they do better in the US, the system is pretty good in a lot of ways, and the fact that it manages to be both cheaper and less bureaucratic than the US system should give Americans real pause for thought.

4 thoughts on “Visiting the Doctor in Italy

  1. I live in Genova and I have to say that I totally disagree. I commonly wait between 1-2 hours to be seen. Once I enter the office, there are no tools the doctors can use to test you for anything. They dole out prescriptions having no clue whether you actually need antibiotics or not. I’ve also been given misinformation by doctors here as well as my Italian husband. I honestly think the doctors here are incompetent and no more reliable than diagnosing yourself on google. I’d gladly pay a copay for quality care. But, to each his own!

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    • You can probably shop around to find a doctor with less of a waiting time, and/or figure out when the best time of day is. Also, my recollection is that appointment times in the US can be pretty approximate as well, and you’re often squeezed in and have to wait.

      As to incompetent: my doctor in the US – many years ago – thought my collapsed lung was ‘asthma’ and he sent me on my way with an inhaler. I think you get bozos everywhere. The people who looked after me after I got checked into the hospital and operated on were first rate.

      The tools they have are pretty much the standard things: stethoscope, stuff to look in your ears, nose, throat… that kind of thing. The same as in the US, unless you go to a specialist.

      You can probably go to a for-pay doctor if you look around.

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  2. The doctor I see here in SICILY is knowledgeable and competent and I have no problem seeing him to ask advice and he has been very helpful with my BP problems. The only problem is you have to be at his office before 8 am to be seen , there is no appointment system and one day his secretary was off ill so another patient decided he would be the assistant and tell people when they could go in to see the doctor …!!!!!! Quite amusing really but it’s a morning out rather than an hour in England to see your Doctor . I find it quite difficult when most people sat in the waiting room were there only for repeat prescriptions and the secretary has to take them into the doctor to sign?? Or allow ?? Between patients …. Why don’t they have a repeat prescription service where you drop it off and collect later that day ???? Is this common in Italy or only SICILY ????

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    • Here in Padova, none of the doctors we’ve been too has had a secretary: you mostly just show up and first come, first served. That’s more or less ok with me though, since usually when I’m sick I just want to see the doctor ASAP, and with appointments, you get squeezed in and have to wait in any case. Most of the prescription people show up and go in between the other patients without taking much time. That bit about a patient deciding to help out sounds funny: that wouldn’t happen elsewhere, would it?

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